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Slide 2 Early Childhood Outcomes Center Using the Child Outcomes Summary Form Robin Rooney Christina Kasprzak The Early Childhood Outcomes (ECO) Center National Early Childhood Technical Assistance Center (NECTAC ) Prepared for the SC Department of Education, September 2007 Slide 3 Early Childhood Outcomes Center 2 What We Will Cover Why collect outcomes data? Understanding the three child outcomes Assessing the accomplishment of the three child outcomes Using the Child Outcomes Summary Form Practice with the Child Outcomes Summary Form Slide 4 Early Childhood Outcomes Center 3 Why Collect Outcomes Data? Slide 5 Early Childhood Outcomes Center 4 Public Policy Context Age of accountability Accountability increasingly means looking at results, not just process Office of Special Education Programs (OSEP) is under increasing pressure to produce outcome data on children participating in early intervention and early childhood special education Slide 6 Early Childhood Outcomes Center 5 PART Review Findings for Part B Preschool Results not demonstrated Part B Preschool The Department has no performance information on preschool children with disabilities served by this program. Read more at ExpectMore.gov Slide 7 Early Childhood Outcomes Center 6 OSEPs Response Required states to submit outcomes data in their Annual Performance Report (APR) Funded the Early Childhood Outcomes (ECO) Center help develop outcome indicators and assist states in meeting them Slide 8 Early Childhood Outcomes Center 7 OSEP Reporting Requirements: Child Outcomes Positive social-emotional skills (including social relationships) Acquisition and use of knowledge and skills (including early language/communication and early literacy) Use of appropriate behaviors to meet their needs Slide 9 Early Childhood Outcomes Center 8 OSEP Reporting Categories Percentage of children who: a.Did not improve functioning b.Improved functioning, but not sufficient to move nearer to functioning comparable to same-aged peers c.Improved functioning to a level nearer to same-aged peers but did not reach it d.Improved functioning to reach a level comparable to same-aged peers e.Maintained functioning at a level comparable to same-aged peers 3 outcomes x 5 measures = 15 numbers Slide 10 Early Childhood Outcomes Center 9 Why Collect Outcome Data? Federal government is the driving force behind the move to collect outcome data Federal government needs aggregated data on outcomes to justify future funding requests However, providing data for the federal government is not the only reason to collect outcome data Slide 11 Early Childhood Outcomes Center 10 Why Collect Outcomes Data? Data on outcomes are important for state and local purposes. To document program effectiveness To improve programs Identify strengths and weaknesses Allocate support resources, such as technical assistance And, ultimately to better serve children and families Slide 12 Early Childhood Outcomes Center 11 Understanding the Three Child Outcomes Slide 13 Early Childhood Outcomes Center 12 Where the outcomes came from ECO convened stakeholders to identify child and family outcome areas and develop outcome statements Received input from state Part C and 619 Coordinators, researchers, families, administrators, and the general public Slide 14 Early Childhood Outcomes Center 13 Goal of Early Intervention/Early Childhood Special Education To enable young children to be active and successful participants during the early childhood years and in the future in a variety of settings in their homes with their families, in child care, in preschool or school programs, and in the community. (from Early Childhood Outcomes Center, http://www.fpg.unc.edu/~eco/pdfs/eco_outcomes_4-13-05.pdf) Slide 15 Early Childhood Outcomes Center 14 Child Outcomes to be Measured, As Required by OSEP Positive social-emotional skills, including social relationships Acquisition and use of knowledge and skills, including early language/communication and early literacy Use of appropriate behaviors to meet their needs Slide 16 Early Childhood Outcomes Center 15 Outcomes Are Functional Functional outcomes: Refer to things that are meaningful to the child in the context of everyday living Refer to an integrated series of behaviors or skills that allow the child to achieve the important everyday goals Slide 17 Early Childhood Outcomes Center 16 Functional Outcomes are NOT A single behavior The sum of a series of discrete behaviors or splinter skills such as.. *Knows 10 words*Pincer grasp (picks up a raisin) *Smiles at mom *Goes up and down stairs with one foot on each stair *Stacks 3 blocks Slide 18 Early Childhood Outcomes Center 17 Functional Outcomes Not domains-based, not separating child development into discrete areas (communication, gross motor, etc.) Refer to behaviors that integrate skills across domains Can involve multiple domains Emphasize how the child is able to carry out meaningful behaviors in a meaningful context Slide 19 Early Childhood Outcomes Center 18 Thinking Functionally (within age-expected bounds) Isolated skill Knows how to imitate a gesture when prompted by others Uses finger in pointing motion Uses 2-word utterances Functional skill Watches what a peer says or does and incorporates it into his/her own play Points to indicate needs or wants Engages in back and forth verbal exchanges with caregivers using 2-word utterances Slide 20 Early Childhood Outcomes Center 19 Thinking Functionally If you know that a child can point, do you know that the child can communicate her wants and needs? If you know that a child cant point, do you know that the child cant communicate his wants and needs? How does knowing about pointing help you understand how the child takes action to meet needs? Slide 21 Early Childhood Outcomes Center 20 Thinking Functionally Discrete behaviors (e.g., those described by some items on assessments) may or may not be important to the childs functioning on the outcome Individually, they are not especially informative Summed, they may or may not be useful, depending on the functionality of the behaviors/items Slide 22 Early Childhood Outcomes Center 21 Children Have Positive Social Relationships Involves: Relating with adults Relating with other children For older children, following rules related to groups or interacting with others Includes areas like: Attachment/separation/autonomy Expressing emotions and feelings Learning rules and expectations Social interactions and play Slide 23 Early Childhood Outcomes Center 22 Children Acquire and Use Knowledge and Skills Involves: Thinking Reasoning Remembering Problem solving Using symbols and language Understanding physical and social worlds Includes : Early conceptssymbols, pictures, numbers, classification, spatial relationships Imitation Object permanence Expressive language and communication Early literacy Slide 24 Early Childhood Outcomes Center 23 Children Take Appropriate Action to Meet Their Needs Involves: Taking care of basic needs Getting from place to place Using tools (e.g., fork, toothbrush, crayon) In older children, contributing to their own health and safety Includes: Integrating motor skills to complete tasks Self-help skills (e.g., dressing, feeding, grooming, toileting, household responsibility) Acting on the world to get what one wants Slide 25 Early Childhood Outcomes Center 24 Outcomes Reflect Global Functioning Each outcome is a snapshot of: The whole child Status of the childs current functioning Functioning across settings and situations Rather than: Skill by skill In one standardized way Split by domains Slide 26 Early Childhood Outcomes Center 25 The Overarching Goal To enable young children to be active and successful participants during the early childhood years and in the future in a variety of settingsin their homes with their families, in child care, in preschool or school programs, and in the community. Slide 27 Early Childhood Outcomes Center 26 Assessing the Accomplishment of the Three Child Outcomes Slide 28 Early Childhood Outcomes Center 27 What Is Assessment? Early childhood assessment is a flexible, collaborative decision-making process in which teams of parents and professionals repeatedly revise their judgments and reach consensus.... Bagnato and Neisworth (1991) Quoted in DEC Recommended Practices (2005) Slide 29 Early Childhood Outcomes Center 28 DEC Recommended Practices for Assessment Involve multiple sources Examples: family members, professional team members, service providers, caregivers Involve multiple measures Examples: observations, criterion- or curriculum- based instruments, interviews, norm-referenced scales, informed clinical opinion, work samples Slide 30 Early Childhood Outcomes Center 29 Assessment Tools Assessment tools can inform us about childrens functioning in each of the three outcome areas Challenge: There is no assessment tool that assesses the three outcomes directly Slide 31 Early Childhood Outcomes Center 30 Assessment Tool Lenses Each assessment tool carries its own organizing framework, or lens Many are organized around domains But the content in the domains isnt always the same, even if the names are the same Key question: How much and what information will a given tool provide about the attainment of the three child outcomes? Slide 32 Early Childhood Outcomes Center 31 Making Use of Assessment Tool Information The ECO Center has crosswalked assessment tools to the outcomes (www.fpg.unc.edu/~eco/crosswalks.cfm) Information from formal or published assessment tools can be very useful, but it needs to be understood and used in the context of achievement of the three outcomes Teams may have additional information that paints a picture of the child that differs from one provided by an assessment. Teams may override the results from an assessment tool Slide 33 Early Childhood Outcomes Center 32 Critical Assumptions Related to the Three Child Outcomes Measuring achievement of the outcomes is based on comparison with age expectations Children of different ages will demonstrate achievement in different ways, so expectations change with age There are many pathways to functioning for children with atypical development (e.g., using sign language, wheelchair). Slide 34 Early Childhood Outcomes Center 33 Assessing Functional Outcomes What does the child usually do? Actual performance across settings and situations How the child uses his/her skills to accomplish tasks Not the childs capacity to function under unusual or ideal circumstances Not necessarily the childs performance in a structured testing situation Slide 35 Early Childhood Outcomes Center 34 Remember This Flexibility is required in applying assessment tool results to the outcomes Teams need to decide what information from an assessment tool is relevant for this child Slide 36 Early Childhood Outcomes Center 35 The Child Outcomes Summary Form (COSF) Slide 37 Early Childhood Outcomes Center 36 Why Is the Child Outcomes Summary Form Needed? No assessment instrument assesses the three outcomes directly Different programs will be using different assessment instruments, and outcome data will need to be aggregated across programs Slide 38 Early Childhood Outcomes Center 37 Features of the Child Outcomes Summary Form It is not an assessment tool It uses information from assessment tools and observations to get a global sense of how the child is doing at one point in time Slide 39 Early Childhood Outcomes Center 38 Features of the Child Outcomes Summary Form 7-point rating scale Rating is based on the childs functioning: What the child does across settings and situations Compared to what is expected given the childs age Scale runs from 1-7 with 6 or 7 indicating age appropriate functioning Lower numbers indicate distant from age appropriate functioning Slide 40 Early Childhood Outcomes Center 39 Summary Ratings (1-7) Provide an overall sense of the childs current functioning in three areas Reduce rich information from assessment and observation into ratings to allow a summary of progress across children Do not provide information for planning for the individual child. Information at the rich, detailed level will be more helpful for intervention planning purposes Slide 41 Early Childhood Outcomes Center 40 The Two COSF Questions a.To what extent does this child show age- appropriate functioning, across a variety of settings and situations, on this outcome? (Rating: 1-7) b.Has the child shown any new skills or behaviors related to [this outcome] since the last outcomes summary? (Yes-No) Slide 42 Early Childhood Outcomes Center 41 Using the Child Outcomes Summary Form (COSF) Slide 43 Early Childhood Outcomes Center 42 Essential Knowledge for Completing the COSF Between them, team members must: 1.Understand the content of the three child outcomes 2.Know about the childs functioning across settings and situations 3.Understand age-expected child development 4.Understand age expectations for child functioning within the childs culture 5.Know how to use the rating scale Slide 44 Early Childhood Outcomes Center 43 Summary Ratings Are Based on Types of Information Curriculum-based assessments (e.g., HELP) Norm-referenced assessments (e.g., BDI-2) Developmental screenings (e.g., Ages & Stages) Observation and report Sources of Information Parents and family members Service providers Therapists Physicians Child care providers Teachers People familiar with the child in all of the settings and situations that he/she is in Slide 45 Early Childhood Outcomes Center 44 Key Points Assumption: Children can be described with regard to how close they are to age-expected functioning for each of the three outcomes By definition, most children in the general population demonstrate the outcome in an age-expected way Over time, some children will move farther away from age- expected functioning (skills at older ages are more demanding) By providing services and supports, programs are trying to move children closer to age-expected functioning Some children will never achieve this Slide 46 Early Childhood Outcomes Center 45 Cultural Differences If the child is from a culture that has expectations that differ from published developmental milestones for when young children accomplish common developmental tasks, such as feeding themselves or dressing themselves, use the expectations for the childs culture to decide if the childs functioning is at the level expected for his or her age Slide 47 Early Childhood Outcomes Center 46 7 Points on the Rating Scale Slide 48 Early Childhood Outcomes Center 47 7 Completely The child shows behaviors and skills expected in all or almost all everyday situations that are part of the childs life Home, store, park, child care, with strangers, etc. The childs functioning is considered appropriate for his/her age No one has significant concerns about the childs functioning in this outcome area Slide 49 Early Childhood Outcomes Center 48 6 Between Completely and Somewhat The childs functioning generally is considered appropriate for his or her age, but there are some significant concerns about the childs functioning in this outcome area Slide 50 Early Childhood Outcomes Center 49 5 Somewhat The child shows functioning expected for his/her age some of the time and/or in some situations The childs functioning is a mix of age- appropriate and not appropriate functioning The childs functioning might be described as like that of a slightly younger child Slide 51 Early Childhood Outcomes Center 50 4 Between a 5 and a 3 Child shows some age appropriate functioning some of the time or in some situations or settings but most of the childs functioning would be described as not yet age appropriate. The childs functioning might be described as like that of a younger child Slide 52 Early Childhood Outcomes Center 51 3 Emerging The child does not yet show functioning expected of a child his/her age in any situation The childs behaviors and skills include immediate foundational skills on which to build age-appropriate functioning The childs functioning might be described as like that of a younger child Slide 53 Early Childhood Outcomes Center 52 2 Between 3 and 1 The child does not yet show functioning expected of a child his/her age in any situation The childs behaviors and skills does have some the immediate foundational skills on which to build age-appropriate functioning but these are not displayed very often The childs functioning might be described as like that of a younger or even much younger child Slide 54 Early Childhood Outcomes Center 53 1 Not Yet The child does not yet show functioning expected of a child his/her age in any situation The childs skills and behaviors also do not yet include any immediate foundational skills on which to build age-appropriate functioning The childs functioning might be described as like that of a much younger child Children with 1 ratings still have skills, just not yet at an immediate foundational level Slide 55 Early Childhood Outcomes Center 54 What are immediate foundational skills? Foundational skills are. Skills and behaviors that occur earlier in development and serve as the foundation for later skill development Teachers and interventionists often use foundational skills to help children move to the next level developmentally Immediate foundational skills are Skills that are conceptually linked to later skills and immediately precede the later skills developmentally Example: Children play alongside one another before they interact in play Slide 56 Early Childhood Outcomes Center 55 Concerns That Distinguish Ratings of 7 vs. 6 All children have strengths and weaknesses. Families and providers identify areas to work on to support ongoing growth (some call these concerns) What types of concerns would result in a rating of 6? Slide 57 Early Childhood Outcomes Center 56 Concerns That Distinguish Ratings of 7 vs. 6 Concerns raised for which families and providers may want to offer extra support and strategies to promote development, but the area of concern is not a possible indicator or precursor of a significant developmental problem (7) vs. Developmental concernsweaknesses significant enough to watch closely and definitely support. Although age expected now, the childs development borders on not keeping pace with age-expected levels or shows early signs of possible developmental problems (6) Slide 58 Early Childhood Outcomes Center 57 Practice Example with the Child Outcomes Summary Form Slide 59 Early Childhood Outcomes Center 58 The Process for Answering Questions 1a, 2a, 3a For each outcome 1.Discuss the childs current functioning in this outcome area across settings and situations 2.Identify areas where the childs functioning is age appropriate 3.If not all functioning is age appropriate, identify areas where the childs functioning reflects immediate foundational skills 4.Decide which rating best describes the childs current functioning Slide 60 Early Childhood Outcomes Center 59 Where to Focus in Deciding the Rating Focus on the childs overall functioning across settings and situations Functioning that is displayed rarely and/or when the child is provided with a lot of unusual support or prompts is of little significance for the rating Slide 61 Early Childhood Outcomes Center 60 Introduction to the Child Example Age 35 months Context Entry COSF Rating at placement meeting just after IEP development Team Preschool Psychologist Preschool Special Educator Speech Language Pathologist Parent Slide 62 Early Childhood Outcomes Center 61 Team Discussion Slide 63 Early Childhood Outcomes Center 62 Frequently Asked Questions Slide 64 Early Childhood Outcomes Center 63 What if there are no concerns in an outcome area? Still do ratings? Yes. Ratings on all three outcomes should be reported for every child enrolled Ratings are needed in all areas even if: No one has concerns about a childs development A child has delays in one or two outcome areas, but not in all three outcome areas Slide 65 Early Childhood Outcomes Center 64 What about children who have only speech articulation problems? Discussion needs to examine whether and how articulation difficulties are affecting the childs functioning with regard to each of the three outcomes Examples: Will anyone play with him/her? Can others understand him/her on the playground? How does he/she convey critical needs (e.g., safety needs)? Depending on the child, discussion could yield ratings of 5, 6, 7 in any of the three areas Ex. Outcome 3: 6 vs. 7 because of potential impact for safety Slide 66 Early Childhood Outcomes Center 65 Can a child have all 7s? YES if the childs disability does not have an impact on his ability to function at age level across outcome areas What are some examples? Slide 67 Early Childhood Outcomes Center 66 What about assistive aechnology and accommodations? Ratings should reflect the childs level of functioning using whatever assistive technology or special accommodations are present in the childs day-to-day settings Slide 68 Early Childhood Outcomes Center 67 Whats important when documenting the rating? On the form, you will need to document: What evidence led to the selected rating, evidence of .. Age expected functioning? Immediate foundational skills Skills and behaviors that will lead to foundational skills Who participated in the conversation and the decision. Documentation provides a record of the rationale for the rating decision Slide 69 Early Childhood Outcomes Center 68 Why is it important to document the rating? Evidence can be reviewed to see whether people are using the system properly (i.e., rating similar children in the same ways) Documentation helps identify needs for future training and technical assistance Documentation may be useful for new team members reviewing the file Slide 70 Early Childhood Outcomes Center 69 When do you answer the progress questions (1b, 2b, 3b) ? Apply only if a Child Outcomes Summary Form has been completed previously Compare the childs current and past behavior Has the child shown any new skills or behaviors in the goal area since the last rating? (Yes or No) Small steps of progress count! Examples Most will select Yes. Slide 71 Early Childhood Outcomes Center 70 What about including parents in the discussion? Parent input about the childs functioning is critical Family members see the child in situations that professionals do not Need to ask family members about what the child does at home The team will need a way to learn what family members know about the child There is no expectation that parents will be able to determine whether what they are seeing is age appropriate Slide 72 Early Childhood Outcomes Center 71 Explaining the Rating to Parents If parents are included in deciding on a rating, professionals will need to be able to explain this process to parents Even if parents are not included in deciding on a rating, professionals will need to be able to explain why the rating is being done and what it means Slide 73 Early Childhood Outcomes Center 72 ECO Center Next Steps for Work on Child Outcomes Additional information, including additional crosswalks, training slides, and materials for parents, will be posted on our website www.the-eco-center.org